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Parents' perception of child and adolescent mental health problems and their choice of treatment option in southwest Ethiopia.

ABSTRACT: BACKGROUND: Parents' perception and awareness about psychiatric illness in children and adolescents is an important determinant of early detection and treatment seeking for the condition. However, there has been limited information about the perception and awareness of parents about these issues as well as their preferred treatment options in Ethiopia. This study is, therefore, aimed at assessing the perception of parents about psychiatric illness in children and adolescents and their preferred treatment options in Jimma, Ethiopia. METHOD: A cross-sectional study was conducted among 532 parents in Jimma City, Ethiopia from April to May 2013. Parents from the city were invited to participate in this study to assess their knowledge on causes, and manifestations of psychiatric illness in children and adolescents as well as their preferred treatment options if their children exhibited signs and symptoms of mental illness. RESULTS: Nearly three quarters of the parents identified genetic factors while approximately 20 % of them mentioned neuro-chemical disturbance as possible causes of their children's mental health problems. On the other hand, magic, curse, and sin were mentioned as causes of mental health problems by 93.2, 81.8 and 73.9 % of the parents, respectively. Externalizing behavioral symptoms like "stealing from home, school or elsewhere" and internalizing symptoms like "being nervous in new situations and easily loses confidence" were perceived by 60.9 and 38.2 % of the parents, respectively. The majority (92.7 %) of parents agreed that they would seek treatment either from religious or spiritual healers if their children developed mental illness. CONCLUSIONS: The low level of awareness about internalizing symptoms, the widespread traditional explanatory models as well as preference for traditional treatment options might present significant challenges to utilization of child and adolescent mental health services in this population. Public health intervention programs targeting parental attitude regarding the causes and treatment for child and adolescent mental health problems need to be designed and evaluated for their effectiveness in low-income settings. Additionally, including religious and spiritual leaders in the process of educating members of their respective churches and mosques should also be explored.

SUBMITTER: Abera M

PROVIDER: S-EPMC4546139 | biostudies-other | 2015

REPOSITORIES: biostudies-other

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Project description:Introduction:Globally, 10-20% of children and adolescents suffer from mental disorders, with half of all them starting by the age of 14 and three-quarters before the age of 25. In Nepal, 40% of the population is younger than 18 years of age, and as such there is a large proportion of the population that is at risk of developing a mental disorder. There has been a recent recognition of child and adolescent mental health problems in Nepal, although prior to this it had remained almost invisible on the health agenda. In response to growing concern, there is a need to conduct a review on children and adolescent mental health problems in Nepal. Objective:To review the existing studies on child and adolescent mental health problems in Nepal. Methodology:A scoping review approach was used to identify studies on child and adolescent mental problems in Nepal. A search of Medline and PubMed databases for articles published from the database inception to August 2018 was conducted. Results:Ten papers were identified, and they all together included 7876 participants. Two studies reported on Post traumatic Stress Symptoms (PTSS) and described a prevalence of 10.7% to 51% of earthquake-affected children and adolescents in the Kathmandu district of Nepal. Another study reported that 53.2% of former child soldiers met the cut-off score for PTSS. Two school surveys found that the prevalence of emotional and behavioural problems in school children ranged between 12.9 and 17.03%, whereas a study on emotional and behavioural disorders in homeless children reported a prevalence of 28.6%. The prevalence of Autism Spectrum Disorder (ASD) was estimated to be as high as three in every 1000 persons in Nepal by one study. The clinical prevalence of anxiety disorders was reported ranging from 18.8% to 24.4% while that of Attention Deficit Hyperactivity Disorder (ADHD) was 10-11.7% in various clinical samples of children and adolescents. Conclusion:Only a few studies on the prevalence of child and adolescent mental health in Nepal have been conducted. Clearly, there is a need for better study design and larger studies to understand more fully the prevalence of child and adolescent mental health disorders in Nepal, in order to adequately plan public health services accordingly.

Project description:ObjectivesThis is a pilot study with the objective of investigating general practitioner (GP) perceptions and experiences in the referral of mentally ill and behaviourally disturbed children and adolescents.DesignQuantitative analyses on patient databases were used to ascertain the source of referrals into Child and Adolescent Mental Health Services (CAMHS) and identify the relative contribution from GP practices. Qualitative semistructured interviews were then used to explore challenges faced by GPs in referring to CAMHS.SettingGPs were chosen from the five localities that deliver CAMHS within the local Trust (Peterborough City, Fenland, Huntingdon, Cambridge City and South Cambridgeshire).ParticipantsFor the quantitative portion, data involving 19 466 separate referrals were used. Seven GPs took part in the qualitative interviews.ResultsThe likelihood of a referral from GPs being rejected by CAMHS was over three times higher compared to all other referral sources combined within the Cambridge and Peterborough NHS Foundation Trust. Interviews showed that detecting the signs and symptoms of mental illness in young people is a challenge for GPs. Communication with referral agencies varies and depends on individual relationships. GPs determine whether to refer on a mixture of the presenting conditions and their perceived likelihood of acceptance by CAMHS; the criteria for the latter were poorly understood by the interviewed GPs.ConclusionsThere are longstanding structural weaknesses in the services for children and young people in general, reflected in poor multiagency cooperation at the primary care level. GP-friendly guidelines and standards are required that will aid in decision-making and help with understanding the referrals process. We look to managers of both commissioning and providing organisations, as well as future research, to drive forward the development of tools, protocols, and health service structures to help aid the recognition and treatment of mental illness in young people.

Project description:Parents of children with physical or mental health problems are at higher risk for experiencing parental stress. However, mothers and fathers may experience parental stress differently. The aim was to examine whether mothers and fathers of children with physical and/or mental health problems are equally inclined within the couples to experience different aspects of parental stress when considering child and parent couple characteristics. Single aspects of Parental stress were assessed with nine items from the Parental Stress Scale in 197 parent couples of children aged 1-18 years with physical and/or mental health problems. Agreement within parent couples for each item was tested using two tests of marginal homogeneity for dependent data: a nominal G2-test and an ordinal γ-test. Analyses were conditioned on child gender, child age, couple educational level, and overall parental stress. For seven aspects of parental stress, differences in agreement within the couples were found with at least one of the conditioning variables. For five aspects (item 3, 4, 9, 10, 13) addressing specific personal experience of daily stressors related to having children and feeling inadequate as a parent, the differences were systematic. Mothers were more inclined to experience these aspect of parental stress than fathers, specially mothers of boys, a younger child, in couples with an education above high school or with a higher stress level. Agreement was found for two aspects (item 14 and 16) of parental stress. This study suggests that mothers' and fathers' experience of most aspects of parental stress vary within the couples. Knowledge on systematic difference between parents' experience of parental stress may inform future interventions. For aspects where mothers generally experience the highest degree of stress, fathers may be involved as support. Future studies may explore the role of diagnoses, coping strategies and examine concordance in parental stress symptoms in other subgroups.

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Parents' perception of child and adolescent mental health problems and their choice of treatment option in southwest Ethiopia.

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